Disturbances of micturation

• Disturbances of Micturation


  Disturbances related to urination
• Frontal lobes play a major part in personality
• Frontal lobe lesions


  • Loss of drive
  • Apathy, lack of interest
  • Decreasing enthusiasm
  • Decreasing concern about personal appearance, hygiene, family affairs, business
  • Memory problems
  • Diminished intellect
  • Weakness - opposite side of face +/or body, bilateral legs if parasagittal
  • loss of micturation control
  • speech disturbance
  • visual (field + acuity)
  • alteration in smell
• Complete spinal bladder lesion

  • Reflex emptying of bladder without warning
  • No ability to stop voiding
  • Evacuation may be interrupted, incomplete
  • Small spastic bladder
  • Hypertonicity, increased stretch reflex, no inhibition due to affected ascending and descending pathways
  • External sphincter doesn't contract
• Normally shows signs of bilateral upper motor neuron lesion
• Incomplete spinal bladder lesion


  • Storage symptoms: Frequency, urgency, may not be able to stop voiding
  • Voiding symptoms: Difficulty initiating, Interruption in flow, Incomplete evacuation - may have a sense of needing to void again within minutes
• Conus lesion


  Lesion at S2-S4 segmental level
• Sub-conus lesion


  e.g. Cauda Equina Syndrome